Vonoprazan-containing therapy has an H pylori eradication rate >90% and increases eradication vs. standard triple therapy

2021 ◽  
Author(s):  
Rashid N. Lui ◽  
Francis K.L. Chan
Keyword(s):  
Triple Therapy ◽  
Eradication Rate ◽  
Standard Triple Therapy ◽  
H Pylori

scholarly journals A study on healing of peptic ulcer disease after eradication of helicobacter pylori infection

2014 ◽  
Vol 43 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Md Razibul Alam ◽  
Ershad Uddin Ahmed ◽  
Md Zahidur Rahman ◽  
ASM Nazmul Islam ◽  
Md Masudur Rahman Khan ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Triple Therapy ◽  
Ulcer Healing ◽  
Eradication Rate ◽  
Helicobacter Pylori Infection ◽  
Ulcer Disease ◽  
Standard Triple Therapy ◽  
H Pylori

There is intimate connection between peptic ulcer & Helicobacter pylori infection. But some uncertainties still surround the relationship between status of H. pylori infection and extent & time required for ulcer healing. This prospective observational study was carried out in the department of Gastroenterology, BSMMU, Dhaka from January 2007 to January 2008 to determine whether the successful eradication of H. pylori leads to adequate ulcer healing. To see the pattern of endoscopic findings in patients still having H. pylori infection after standard triple therapy for H. pylori were also a objective. Eighty nine consecutive patients, aged 15-60 years and of both genders, coming to the gastroenterology outpatient department with the symptoms suggestive of peptic ulcer disease and dyspepsia were included and H. pylori status was defined as positive if both rapid urease test & histopathology were positive. As found in this study, H. pylori was associated with 90% of duodenal ulcers and 80% of gastric ulcers. H. pylori eradication rate was 69%. Healing rate of duodenal ulcer and gastric ulcer after standard triple therapy for 14 days were 80% and 78% respectively. Adequate ulcer healing was achieved in this study despite relatively low eradication rate. Follow-up for additional period is required for recurrence of ulcer in 84 patients whose peptic ulcer disease had resolved but could not attain H. pylori eradication and H. pylori eradicated patients who are still having ulcer at endoscopy DOI: http://dx.doi.org/10.3329/bmj.v43i2.21388 Bangladesh Med J. 2014 May; 43 (2): 84-89

scholarly journals Modified Sequential Therapy Regimen versus Conventional Triple Therapy forHelicobacter pyloriEradication in Duodenal Ulcer Patients in China: A Multicenter Clinical Comparative Study

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Ying-Qun Zhou ◽  
Ling Xu ◽  
Bing-Fang Wang ◽  
Xiao-Ming Fan ◽  
Jian-Ye Wu ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Sequential Therapy ◽  
Burning Pain ◽  
Standard Triple Therapy ◽  
Group A ◽  
H Pylori ◽  
Group B

Objective. Antimicrobial resistance has decreased eradication rates forHelicobacter pyloriinfection worldwide. To observe the effect of eradicatingHelicobacter pylori (H. pylori)and the treatment of duodenal ulcer by 2 kinds of modified sequential therapy through comparing with that of 10-day standard triple therapy.Methods. A total of 210 patients who were confirmed in duodenal ulcer active or heal period by gastroscopy andH. pyloripositive confirmed by rapid urease test, serum anti-H. pyloriantibody (ELASE), or histological examination enrolled in the study. All the patients were randomly divided into three groups: group A (70 cases) and group B (70 cases) were provided 10-day modified sequential therapy; group C (70 cases) was provided 10-day standard triple therapy. Patients of group A received 20 mg of Esomeprazole, 500 mg of Clarithromycin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group B received 20 mg of Esomeprazole, 1000 mg of Amoxicillin for the first 5 days, followed by 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for the remaining 5 days. Group C received 20 mg of Esomeprazole, 500 mg of Clarithromycin, and 1000 mg of Amoxicillin for standard 10-day therapy. All drugs were given twice daily.H. pylorieradication rate was checked four to eight weeks after taking the medicine by using a13C urea breath test. In the first, second, third, seventh, twenty-first, thirty-fifth days respectively, the symptoms of patients such as epigastric gnawing, burning pain, and acidity were evaluated simultaneously.Results. Overall, 210 patients accomplished all therapy schemes, 9 case patients were excluded. The examination result indicated that theH. pylorieradication rate of each group was as follows: group A 92.5% (62/67), group B 86.8% (59/68), and group C 78.8% (52/66). TheH. pylorieradication rate of group A was slightly higher than group B (P<0.05) and both of them were obviously higher than group C (P<0.05). Modified sequential therapy was significantly more effective in patients with clarithromycin-resistant strains (80%/67% versus 31%;P=0.02). Symptoms improvement: all the three groups could improve the symptoms such as epigastric gnawing, burning pain, and acidity since the first day. There was no significant difference in total score descending of symptoms between each group (P>0.05).Conclusions. All the three therapy schemes could alleviate symptoms of duodenal ulcer patients in China efficiently. But as far as eradicatingH. pyloriis concerned, the modified sequential therapy was better than standard triple therapy, especially the therapy scheme used in group A.

scholarly journals First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Chih-Ming Liang ◽  
Chien-Hua Chiu ◽  
Hsing-Ming Wang ◽  
Wei-Chen Tai ◽  
Chih-Chien Yao ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Kidney Diseases ◽  
First Line ◽  
Clinical Factor ◽  
Standard Triple Therapy ◽  
Stage 4 ◽  
Ckd Stage ◽  
H Pylori

Aims. Patients with chronic kidney disease (CKD) and Helicobacter pylori (H. pylori) infection have a higher incidence of gastroduodenal diseases and therefore are recommended to receive eradication therapies. This study aimed to assess the efficacy of a 7-day standard triple therapy in patients with CKD (eGFR < 60 ml/min/1.73 m2) and to investigate the clinical factors influencing the success of eradication. Methods. A total of 758 patients with H. pylori infection receiving a 7-day standard first-line triple therapy between January 1, 2013, and December 31, 2014, were recruited. Patients were divided into two groups: CKD group (N=130) and non-CKD group (N=628). Results. The eradication rates attained by the CKD and non-CKD groups were 85.4% and 85.7%, respectively, in the per-protocol analysis (p=0.933). The eradication rate in CKD stage 3 was 84.5% (82/97), in stage 4 was 88.2% (15/17), and in those who received hemodialysis was 87.5% (14/16). There were no significant differences in the various stages of CKD (p=0.982). The adverse events were similar between the two groups (3.1% versus 4.6%, p=0.433). Compliance between the two groups was good (100.0% versus 99.8%, p=0.649). There was no significant clinical factor influencing the H. pylori eradication rate in the non-CKD and CKD groups. Conclusions. This study suggests that the H. pylori eradication rate and adverse rate in patients with CKD are comparable to those of non-CKD patients.

scholarly journals COMPARISON OF EFFECTIVENESS OF STANDARD TRIPLE THERAPY VERSUS BISMUTH-BASED THERAPY FOR THE MANAGEMENT OF PEPTIC ULCER DISEASE DUE TO HELICOBACTER PYLORI

2020 ◽  
pp. 192-195
Author(s):  
MIRZA MISBA ALI BAIG ◽  
UZMA PARVEEN ◽  
RUQAIAH FAROOQ ◽  
MAIMUNA TABASSUM ◽  
FATIMA NAAZ ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Therapy Group ◽  
Quadruple Therapy ◽  
Ulcer Disease ◽  
Standard Triple Therapy ◽  
H Pylori

Objective: Helicobacter pylori is the primary agent causing peptic ulcer, therefore imposing a significant impact on health elated quality of life, consequently affecting nearly 50% of global population. The objective of this study is to determine and assess the effectiveness of triple therapy versus bismuth containing quadruple therapy for eradication of peptic ulcer disease due to H. pylori. Methods: A prospective randomized observational study was conducted at Princess Esra Hospital, Department of Gastroenterology for a period of 6 months. A total of 100 patients were randomly allocated in tow groups. The data were assessed using various parameters. H. pylori eradication was validated using rapid urease test done at the start treatment 4 weeks after the completion. Results: A total of 100 patients were recruited in the study. In triple therapy group medication adherence rate was found to be 82% in triple and 92% in quadruple therapy. The eradication rate was assessed using Chi-square test it was 82% and 97% in triple and quadruple therapy group, respectively. Hence, the difference was found to be statistically significant value <0.005. In addition, increased recurrence rate has been observed in triple therapy (17%) in contrast with quadruple therapy (2%). Conclusion: Addition of bismuth to significant triple therapy improves cure rates with minimal side effects. Interestingly, we observed that when bismuth was added, it produced a significant higher eradication rate (97%) when compared with standard triple therapy (82%). According to our study, bismuth is highly effective treatment of peptic ulcer disease.

scholarly journals Efficacy and gut dysbiosis of gentamicin-intercalated smectite as a new therapeutic agent against Helicobacter pylori in a mouse model

2020 ◽  
Author(s):  
Su Jin Jeong ◽  
Kyoung Hwa Lee ◽  
Jie-Hyun Kim ◽  
Soon Young Park ◽  
Young Goo Song
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Gastric Mucosa ◽  
Triple Therapy ◽  
Eradication Rate ◽  
Therapeutic Agent ◽  
Fecal Microbiome ◽  
Microbiome Composition ◽  
Standard Triple Therapy ◽  
H Pylori

AbstractBackgroundHelicobacter pylori eradication rate with conventional standard therapy is decreasing owing to antibiotic resistance, necessitating novel antibacterial strategies against H. pylori. We evaluated the efficacy of a gentamicin-intercalated smectite hybrid (S-GM)-based treatment, and analyzed fecal microbiome composition in H. pylori-infected mice.MethodologyTo evaluate anti-H. pylori efficacy, mice were divided into eight groups, and H. pylori eradication was assessed by Campylobacter-like organism (CLO) test and PCR assay of H. pylori in gastric mucosa. One week after H. pylori eradication, proinflammatory cytokine levels and atrophic changes in gastric mucosa were examined. Stool specimens were collected and analyzed for microbiome changes. The S-GM-based triple regimen decreased bacterial burden in vivo, compared with that in untreated mice or mice treated with other regimens. The therapeutic reactions in the CLO test from gastric mucosa were both 90% in standard triple therapy and S-GM therapy group, respectively. Those of H. pylori PCR in mouse gastric mucosa were significantly lower in standard triple therapy and S-GM therapy groups than in non-treatment group. Toxicity test results showed that S-GM therapy reduced IL-8 level and atrophic changes in gastric mucosa. Stool microbiome analysis revealed that compared with mice treated with the standard triple therapy, mice treated with the S-GM therapy showed microbiome diversity and abundant microorganisms at the phylum level.ConclusionOur results suggested that S-GM is a promising and effective therapeutic agent against H. pylori infection.Author summaryThe eradication rate on Helicobacter pylori (H. pylori) showed decreasing trend due to antibiotic resistance, especially clarithromycin. Therefore, we made a smectite hybrid as a drug delivery system using aminoglycosides antibiotic-gentamicin, and applied it to the mouse stomach wall to confirm the localized therapeutic effect, and set the different treatment duration to verify the effect. As a result, it was confirmed that the therapeutic efficacy of gentamicin (GM)-intercalated smectite hybrid (S-GM) was not inferior to the existing standard triple therapy, based on amoxicillin and clarithromycin, and preserved the diversity of gut microbiome composition. Therefore, a S-GM treatment is expected to be a new alternative regimen to H. pylori infection.

scholarly journals Proton Pump Inhibitor Switching Strategy after Failure of Standard Triple Therapy for Helicobacter pylori Infection

2020 ◽  
Vol 20 (2) ◽  
pp. 146-152
Author(s):  
Jaeyoung Kim ◽  
Yeon-Ji Kim ◽  
Woo Chul Chung
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Eradication Rate ◽  
Control Group ◽  
Second Line ◽  
Observation Study ◽  
Standard Triple Therapy ◽  
H Pylori

Background/Aims: It is still unknown whether cytochrome P450 (CYP) 2C19 polymorphisms influence <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication, especially in eastern Asia. We aimed to evaluate how changes in proton pump inhibitor (PPI) strategies could be used to overcome the effects of CYP2C19 polymorphism on <i>H. pylori</i> eradication rate when it is used as the second-line regimen after the failure of standard triple therapy.Materials and Methods: We performed a retrospective observation study of 675 patients in whom standard triple therapy for <i>H. pylori</i> infection was not effective between January 2009 to December 2018. All patients underwent a classic bismuth-containing quadruple therapy (10 to 14-day regimen), and their eradication rates were evaluated for several years. We compared the eradication rates in patients with or without the second-line PPI switch. Further, we assessed differences in eradication rates with or without the strategy using esomeprazole and rabeprazole, which are not influenced significantly by CYP2C19 genetic polymorphism.Results: The eradication rate was 81.0% in individuals who received the second-line PPI switch, but it was 74.8% without switching (<i>P</i>=0.14). In the strategy using esomeprazole and rabeprazole, the eradication rate was 84.6%, compared to 76.5% in the control group (<i>P</i>=0.03). Finally, in the group of patients who switched to rabeprazole, the eradication rates were 85.6%, compared to 77.6% in the group who switched to pantoprazole (<i>P</i>=0.05).Conclusions: Switching to PPI, which is not influenced by CYP2C19 genetic polymorphism, increases the efficiency of eradication after the failure of standard triple therapy.

scholarly journals Standard Triple Therapy versus Sequential Therapy inHelicobacter pyloriEradication: A Double-Blind, Randomized, and Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Jaime Natan Eisig ◽  
Tomás Navarro-Rodriguez ◽  
Ana Cristina Sá Teixeira ◽  
Fernando Marcuz Silva ◽  
Rejane Mattar ◽  
...  
Keyword(s):  
Triple Therapy ◽  
Controlled Trial ◽  
Sequential Therapy ◽  
Rapid Urease Test ◽  
Double Blind ◽  
Intention To Treat ◽  
Standard Triple Therapy ◽  
Urease Test ◽  
H Pylori ◽  
Triple Treatment

Aim. To compare 10-day standard triple therapy versus sequential therapy as first-line treatment in patients infected withH. pylori.Methods. One hundredH. pyloripositive patients (diagnosed by rapid urease test and histology), with average age of 47.2, M/F = 28/72, were randomized to receive either standard triple treatment (TT) as follows: lansoprazole 30 mg, clarithromycin 500 mg, and amoxicillin 1 g, b.i.d. for ten days, or sequential treatment (ST) as follows: lansoprazole 30 mg, amoxicillin and placebo 1.0 g b.i.d for the first five days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and tinidazole 500 mg b.i.d, for the remaining five days. Eradication rates were determined 60 days after treatment by urease, histology, or13C-urea breath test.Results. In intention to treat (ITT) analysis, the rate ofH. pylorieradication in the TT and ST groups was the same for both regimens as follows: 86% (43/50), 95% CI 93,3 to 73.4%. In Per protocol (PP) analysis, the rate ofH. pylorieradication in the TT and ST groups was 87.8% (43/49), 95% CI 94,5 to 75.3% and 89.6% (43/48), 95% CI 95,8 to 77.3%, respectively.Conclusions. In Brazil, standard triple therapy is as equally effective as sequential therapy in eradicatingHelicobacter pyloripatients. This study was registered under Clinical Trials with numberISRCTN62400496.

scholarly journals The Effects of Synbiotic “Bifidobacterium lactisB94 plus Inulin” Addition on Standard Triple Therapy ofHelicobacter pyloriEradication in Children

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Gonca Handan Ustundag ◽  
Halime Altuntas ◽  
Yasemin Dilek Soysal ◽  
Furuzan Kokturk
Keyword(s):  
Triple Therapy ◽  
Standard Therapy ◽  
Therapy Group ◽  
Symptom Relief ◽  
Standard Therapy Group ◽  
Bifidobacterium Lactis ◽  
Standard Triple Therapy ◽  
H Pylori ◽  
Intent To Treat ◽  
Infection Eradication

Aim. The aim of this study is to evaluate the effects of the synbioticBifidobacterium lactisB94 plus inulin addition to the standard triple therapy onHelicobacter pylori (H. pylori)infection eradication rates.Methods. Children aged 6–16 years who had biopsy provenH. pyloriinfection were randomly classified into two groups. The first group received the standard triple therapy consisting of amoxicillin + clarithromycin + omeprazole. The second group was treated with the standard triple therapy andBifidobacterium lactisB94 (5 × 109 CFU/dose) plus inulin (900 mg) for 14 days, concurrently. Eradication was determined by14C-urea breath test 4–6 weeks after therapy discontinuation.Results. From a total of 69H. pyloriinfected children (F/M = 36/33; mean ± SD = 11.2 ± 3.0 years), eradication was achieved in 20/34 participants in the standard therapy group and 27/35 participants in the synbiotic group. The eradication rates were not significantly different between the standard therapy and the synbiotic groups [intent-to-treat, 58.8% and 77.1%, resp.,p= 0.16; per-protocol, 64.5% and 81.8%, resp.,p= 0.19]. There was no difference between the groups in terms of symptom relief (p= 0.193). The reported side effects were ignorable.Conclusion. Considering the eradication rates, synbiotic addition to therapy showed no superiority over the standard triple therapy conducted alone. This trial is registered withNCT03165253.

scholarly journals Factors affecting Helicobacter pylori eradication using a seven-day triple therapy with a proton pump inhibitor, tinidazole and clarithromycin, in brazilian patients with peptic ulcer

2001 ◽  
Vol 56 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Fernando Marcuz Silva ◽  
Schlioma Zaterka ◽  
Jaime Natan Eisig ◽  
Ethel Zimberg Chehter ◽  
Décio Chinzon ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Proton Pump Inhibitor ◽  
Triple Therapy ◽  
Proton Pump ◽  
Eradication Rate ◽  
Response To Therapy ◽  
Urease Test ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
H Pylori

Triple therapy is accepted as the treatment of choice for H. pylori eradication. In industrialized countries, a proton pump inhibitor plus clarithromycin and amoxicillin or nitroimidazole have shown the best results. Our aims were: 1. To study the eradication rate of the association of a proton pump inhibitor plus tinidazole and clarithromycin on H. pylori infection in our population. 2. To determine if previous treatments, gender, age, tobacco, alcohol use, and non-steroidal anti-inflammatory drugs (NSAIDs) change the response to therapy. METHODS: Two hundred patients with peptic ulcer (upper endoscopy) and H. pylori infection (histology and rapid urease test - RUT) were included. A proton pump inhibitor (lansoprazole 30 mg or omeprazole 20 mg), tinidazole 500 mg, and clarithromycin 250 mg were dispensed twice a day for a seven-day period. Eradication was assessed after 10 to 12 weeks of treatment through histology and RUT. RESULTS: The eradication rate of H. pylori per protocol was 65% (128/196 patients). This rate was 53% for previously treated patients, rising to 76% for not previously treated patients, with a statistical difference p<0.01. No significant difference was observed regarding sex, tobacco use, alcohol consumption, and NSAID use, but for elderly patients the difference was p = 0.05. Adherence to treatment was good, and side effects were mild. CONCLUSIONS: A proton pump inhibitor, tinidazole, and clarithromycin bid for seven days resulted in H. pylori eradication in 65% of the patients. Previous treatments were the main cause of treatment failure.

scholarly journals A 14-Day Course of Triple Therapy is Superior to a 10-Day Course for the Eradication ofHelicobacter pylori: A Canadian Study Conducted in a ‘Real World’ Setting

2015 ◽  
Vol 29 (8) ◽  
pp. e7-e10 ◽  
Author(s):  
Yen-I Chen ◽  
Carlo A Fallone
Keyword(s):  
Triple Therapy ◽  
Eradication Rate ◽  
Day Treatment ◽  
Office Visit ◽  
First Line ◽  
Intention To Treat ◽  
Treatment Naïve ◽  
Gastric Biopsies ◽  
H Pylori ◽  
Treat Analysis

BACKGROUND: SuccessfulHelicobacter pylorieradication with the traditional seven-day course of proton pump inhibitor (PPI) triple therapy is declining. Prolonging therapy to either 10 or 14 days is associated with better eradications rates.OBJECTIVE: To compare the effectiveness of 14-day course of triple therapy versus a 10-day course in the treatment ofH pyloriin Canada.METHODS: Consecutive treatment-naive patients with clinical indications forH pylorieradication underwent either a 10-day course or a 14-day course of traditional PPI triple therapy depending on the date of the office visit (an odd date received the 10-day course, whereas an even date received the 14-day treatment).H pylorieradication was ascertained via urea breath test or gastric biopsies performed ≥4 weeks after completion of therapy. Analyses were by both intention to treat and per-protocol.RESULTS: A total of 83 patients were included in the study (31 in the 10-day group and 52 in the 14-day group). In the intention-to-treat analysis, eradication rates were 82.7% (95% CI 70% to 92%) versus 45.2% (95% CI 27% to 64%), favouring the 14-day treatment (P<0.001). Similarly, in the per-protocol analysis, eradication rates were 91.5% (95% CI 80% to 98%) versus 63.6% (95% CI 41% to 83%), favouring the 14-day arm (P=0.01). Adverse events and compliance were not significantly different between the two groups.CONCLUSION: A 14-day course of standard PPI triple therapy was superior to a shorter-duration therapy and should be included as a first-line regimen forH pylorieradication in Canada. The 10-day course of treatment did not achieve an acceptable eradication rate and should no longer be used in this country.

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